Provider Demographics
NPI:1538823810
Name:WEIDNER, LEAH MARIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:WEIDNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:MARCHANTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 BERKSHIRE CT STE 1
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1224
Mailing Address - Country:US
Mailing Address - Phone:610-374-7400
Mailing Address - Fax:610-374-1641
Practice Address - Street 1:40 BERKSHIRE CT STE 1
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1224
Practice Address - Country:US
Practice Address - Phone:610-374-7400
Practice Address - Fax:610-374-1641
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily